Individual provider · NPI-1

Jaclyn Marie Mignella, APRN

Nurse Practitioner, Family · Daytona Beach, FL

NPI number1124582085
StatusActive
Last updated in NPPESSep 20, 2023

Details

NPI
1124582085
Entity type
Individual (NPI-1)
Name
Mrs. Jaclyn Marie Mignella
Credential
APRN
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 24, 2019
Certification date
Sep 20, 2023
Last updated
Sep 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family11028116FLYes
163WR0006X Registered Nurse, Registered Nurse First AssistantRN9277984FL

Practice location

305 Memorial Medical Pkwy Ste 209
Daytona Beach, FL 32117-5169

Phone 386-231-3520

Mailing address

305 Memorial Medical Pkwy Ste 209
Daytona Beach, FL 32117-5169

Phone 386-231-3520

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